Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation Surgery

H. Ince
2003 Circulation  
Surgery Percutaneous Endovascular Repair of Aneurysm After Previous Coarctation http://circ.ahajournals.org/cgi/content/full/108/24/2967 located on the World Wide Web at: The online version of this article, along with updated information and services, is Background-Formation of aortic aneurysm late after surgical repair of coarctation carries a significant risk of rupture and lethal outcome, and repeat surgery is associated with a 14% in-hospital mortality rate and morbidity from paraplegia,
more » ... ury to the central nervous system, or from bleeding. The potential of nonsurgical endovascular repair by the use of stent-grafts in lieu of repeat surgery for postcoarctation aneurysm is unknown. Methods and Results-The concept of postsurgical endovascular stent-graft placement was evaluated with respect to feasibility and safety in 6 consecutive patients with late aneurysm formation after coarctation repair. All patients had aneurysm formation late after patch aortoplasty; placement of an elephant trunk during surgical repair of secondary type I dissection preceded formation of a local aneurysm in 2 cases. Patient age was 49Ϯ12 years, ranging from 31 to 68 years. Transluminal placement of customized stent-grafts was successful, with no 30-day or 1-year intervention-related mortality or morbidity. Follow-up survey of 11 to 47 months revealed optimal reconstruction of the thoracic aorta; 1 patient died 11 months after endovascular repair from cancer. Conclusions-Nonsurgical aortic reconstruction of postsurgical thoracic aneurysms forming late after coarctation repair is safe and feasible; interventional stent-graft placement has the potential to avoid repeat surgery of postsurgical aortic aneurysm.
doi:10.1161/01.cir.0000106902.51626.af pmid:14662704 fatcat:5sgiyxbf6vbrzoa7vmoxwl7os4